Medical conditions involving pelvic prolapse are conditions of great importance. An aging population can be prone to such conditions. Pelvic prolapse develops when intra-abdominal pressure, muscle failure, a surgical procedure such as a hysterectomy, or other factors, allow or cause a tissue of a pelvic organ such as the vagina to become displaced. Within the general category of pelvic organ prolapse, specific types include vault prolapse (apical); cystocele (anterior); rectocele and enterocele (posterior); and combinations of these.
Various techniques have been designed to correct or ameliorate prolapse and prolapse symptoms, with varying degrees of success. Nonsurgical treatments involve measures to improve the factors associated with prolapse, including treating chronic cough, obesity, and constipation. Other nonsurgical treatments may include pelvic muscle exercises or supplementation with estrogen.
A variety of surgical procedures have also been attempted for the treatment of prolapse. See for example U.S. patent application Ser. No. 10/834,943, entitled “Method and Apparatus for Treating Pelvic Organ Prolapse,” filed Apr. 30, 2004, and Ser. No. 10/306,179, entitled “Transobturator Surgical Articles and Methods,” filed Nov. 27, 2002, the entireties of each of these two patent applications being incorporated herein by reference. Such patent applications describe articles and methods for treating pelvic organ prolapse by use of a support member for supporting specific tissue. Application Ser. No. 10/834,943, for example, discusses a support member that includes a central tissue support portion and two end (extension) portions, and related methods for implantation. The central tissue support portion can be attached at tissue of a vaginal vault. The end portions of the support member are then positioned through respective tissue pathways extending to an external incision at the perirectal region, to place the support member in a therapeutic position.
Methods of supporting vaginal tissue to treat vaginal prolapse can be differentiated in terms of the location of implanted materials or anatomical tissue used to support the vaginal tissue. One current method of treating posterior vaginal tissue prolapse involves the use of an intravaginal slingplasty (“IVS”) tunneler device. Methods of treating prolapse using an IVS tunneler involve supporting vaginal tissue by attaching a portion of a surgical implant to vaginal tissue and passing another portion of the implant through the iliococcygeus muscle below the white line, for support. A different technique, known as sacrospinous ligament fixation, involves supporting vaginal tissue by attachment to the sacrospinous ligaments. Both of these methods have drawbacks, such as not providing completely correct anatomical support for the vagina. Attaching vaginal tissue to the sacrospinous ligaments can pull the vagina down toward the pelvic floor. The use of an IVS tunneler to pass an implant through the iliococcygeous muscle allows for support from a location higher up in the anatomy, but still not an anatomically correct location.